Prevalence, type, and related factors of adverse childhood experiences among community mental health outreach users: A four‐year retrospective cohort study

Adverse childhood experiences (ACEs) have been reported to have a detrimental impact on future mental health. However, limited research exists on how mental health staff perceive service users' ACEs. This study examined the prevalence, types, and related factor of staff-perceived ACEs among community outreach service users using 4-year retrospective data. In this retrospective study conducted using service records from the mental health outreach service in Japan, we collected demographic and clinical characteristics, as well as the number and types of ACEs perceived by staff at six assessment points, from registration to 4 years post-service initiation. We compared each clinical characteristic between groups with and without staff-perceived ACEs using independent t-tests and χ 2 tests. To analyze changes in staff-perceived ACEs at six time periods, repeated measures mixed models were used, adjusting for sex, age, and diagnosis. Of the 143 participants whose data were analyzed, the prevalence of ACEs was 54.5%. ACEs were associated with younger age and receipt of public welfare owing to economic deprivation. The number of ACEs notably increased from registration to 6 months post-service initiation and continued to increase 2 years after service initiation and stabilized. More than half of the participants had ACEs. Outreach service users with ACEs were generally younger and faced economic challenges. While most service users' ACEs are recognized within the first 6 months, it is important to note that they may gradually become apparent over a long period, such as 2 years.